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Peripheral microvascular dysfunction is also present in patients with ischemia and no obstructive coronary artery

Camillo L C Junqueira1, Esmeralci Ferreira1,2, Adriana S M Junqueira3

  • 1Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.

Clinical Hemorheology and Microcirculation
|June 21, 2021
PubMed

Insights

Microvascular dysfunction in patients with ischemia and no obstructive coronary artery disease (INOCA) can be detected in peripheral circulation. This finding may improve diagnosis and management of INOCA patients, potentially reducing major adverse cardiovascular events.

Area of Science:

  • Cardiovascular Medicine
  • Microcirculation Research
  • Diagnostic Imaging

Background:

  • Coronary microvascular dysfunction in Ischemia and No Obstructive Coronary Artery disease (INOCA) is linked to increased major adverse cardiovascular events.
  • Noninvasive detection of peripheral microvascular dysfunction could offer a diagnostic advantage.

Purpose of the Study:

  • To investigate if microvascular dysfunction in the coronary circulation of INOCA patients is detectable in their peripheral circulation.
  • To assess peripheral microvascular function using noninvasive techniques.

Main Methods:

  • Nailfold videocapillaroscopy (NVC) and venous occlusion plethysmography (VOP) were used to evaluate peripheral microvascular function in 25 INOCA patients and 25 controls.
  • Blood samples were analyzed for biomarkers including soluble vascular cell adhesion molecule-1 (sVCAM-1), endothelin-1 (ET-1), and C-reactive protein (CRP).

Main Results:

  • Patients with INOCA exhibited significantly lower red blood cell velocity (RBCVmax) and longer time to reach maximal velocity (TRBCVmax).
  • VOP revealed significantly lower maximal blood flow and its relative increment in INOCA patients.
  • RBCVmax and post-ischemic blood flow increments showed significant correlations with sVCAM-1, ET-1, and CRP levels.

Conclusions:

  • Impaired microvascular function in the coronary circulation of INOCA patients is also detectable in their peripheral circulation.
  • Peripheral microvascular assessment may serve as a noninvasive method for detecting dysfunction in INOCA.
Abstract

Keywords:
Ischemia and no obstructive coronary artery diseasemicrovascular dysfunctionnailfold videocapillaroscopyvenous occlusion plethysmography

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